Your application is the first step in the process of obtaining employment with the Greater Orlando Aviation Authority. PLEASE
READ ALL INSTRUCTIONS CAREFULLY AND COMPLETE ALL STATEMENTS TO THE BEST OF YOUR KNOWLEDGE.
Please review the “Summary of Your rights under the Fair Credit Reporting Act” before completing the application form.

1. APPLICATION FOR EMPLOYMENT:

Personal Data:

Address should be correct mailing address and a phone number should be included. If you do not have a home
phone, please include a phone number where you can be reached and/or a message taken

Employment Data Questionnaire

Answer all questions completely

Driver’s License Data:

Answer all questions completely

Please include all endorsements if any

Please include any traffic violations you have received within the last three (3) years

Educational and Training Data:

Check the highest level of school completed

Be accurate in giving type of degree, major and minor, and semester/quarter hours

Any vocational training should also include the number of classroom hours

List all employment. Make sure you have at least the most recent ten (10) years of employment history

Please account for any gaps between employments over the ten (10) year period

Please give complete company address, phone number and name of immediate supervisor for all jobs listed

A resume may be attached; however, the application must be completed for employment history record

References and Signature:

Please list two persons not related to you

Please read and initial each paragraph

Your signature must be included for the application to be valid. (If employment application was completed and
submitted online, your signature will be obtained if selected for an interview)

2. VETERANS’ PREFERENCE FORM

3. EEO RECORD KEEPING

4. DISCLOSURE

NOTE: ALL applicants selected for employment will be required to successfully pass a pre-employment physical examination which
includes drug testing, background check and security badge process including fingerprinting.

All statements should be complete and accurate to the best of your knowledge. Falsification of information may result in rejection of
the application or dismissal if you are employed by the Greater Orlando Aviation Authority.

The Greater Orlando Aviation Authority is an Equal Opportunity Employer and applicants will be considered without regard to race,
color, religion, age, sex, sexual orientation, disability, national origin, marital status, or genetic information.

Persons with a disability requiring an accommodation for testing must contact (407) 825-2625 or notify Human Resources at the time
of application submission.

EQUAL OPPORTUNITY EMPLOYER: It is our policy to abide by all Federal, State and Local laws prohibiting employment discrimination on the basis of a person’s race, color, creed, national origin, religion, age, sex, sexual orientation, marital status, or disability, except where a reasonable bona fide occupational qualification exists.

** If you are asserting Veteran’s Preference, please fill out the enclosed Application for Veteran’s Preference.

VI. Employment History:
List present and all positions held during the most recent ten years. Indicate month and year. (Present employer first.) Due to the Federal Aviation Authority regulations, it is required for all employees to account for all employment over the last ten (10) years. This also includes any timeframe that there was not employment.Please explain any gaps in employment history.

Employer

Kind of Business

Employer’s Address

Phone #

Position Held

Salary $

Supervisor's Name

Dates of Employment:

From (mm/yy)

To (mm/yy)

Reason for Leaving

Description of Duties

Employer

Kind of Business

Employer’s Address

Phone #

Position Held

Salary $

Supervisor's Name

Dates of Employment:

From (mm/yy)

To (mm/yy)

Reason for Leaving

Description of Duties

Employer

Kind of Business

Employer’s Address

Phone #

Position Held

Salary $

Supervisor's Name

Dates of Employment:

From (mm/yy)

To (mm/yy)

Reason for Leaving

Description of Duties

Employer

Kind of Business

Employer’s Address

Phone #

Position Held

Salary $

Supervisor's Name

Dates of Employment:

From (mm/yy)

To (mm/yy)

Reason for Leaving

Description of Duties

Employer

Kind of Business

Employer’s Address

Phone #

Position Held

Salary $

Supervisor's Name

Dates of Employment:

From (mm/yy)

To (mm/yy)

Reason for Leaving

Description of Duties

Employer

Kind of Business

Employer’s Address

Phone #

Position Held

Salary $

Supervisor's Name

Dates of Employment:

From (mm/yy)

To (mm/yy)

Reason for Leaving

Description of Duties

Employer

Kind of Business

Employer’s Address

Phone #

Position Held

Salary $

Supervisor's Name

Dates of Employment:

From (mm/yy)

To (mm/yy)

Reason for Leaving

Description of Duties

Employer

Kind of Business

Employer’s Address

Phone #

Position Held

Salary $

Supervisor's Name

Dates of Employment:

From (mm/yy)

To (mm/yy)

Reason for Leaving

Description of Duties

VI. References: List two (2) persons, not related to you, who have knowledge of your character.

Name

Occupation

Address

Phone #

Name

Occupation

Address

Phone #

Please initial by each paragraph acknowledging that you have read and understand each statement listed
below. If you have any questions regarding the following statements, please ask before signing.

(Initial) The Greater Orlando Aviation Authority (the “Aviation Authority”) does not discriminate in hiring or employment on the basis of race, color, religion, sex, sexual orientation, national origin, age, disability, marital status, genetic information, or status within any other protected group. No questions on this application are intended to secure information to be used for such discrimination.

(Initial) I hereby certify that the answers and statements given by me in this application are correct and without consequential omissions of any kind. I agree that a false statement or omission may result in the
withdrawal of any employment offer or dismissal from employment resulting in this application. I agree that the
Aviation Authority shall not be liable in any respect if my employment is terminated because of the falsity of
statement, answers, or omissions made by me on this application.

(Initial) I understand that all statements made by me in connection with my application for employment may be checked by the Aviation Authority. I understand that the Aviation Authority may obtain an investigative
consumer report about me and I authorize all persons, corporations, or organizations and the Aviation Authority
and their agents to release any and all records and information pertaining to my employment history, police
record, education background, military service, driver’s license records or personal reputation and hereby
release and indemnify all parties from liability for damage and agree to hold them harmless for providing this
information. I also understand that I have the right to request additional information about the nature and scope
of the investigative report about me that the Aviation Authority may request. If such a request is made, the
Aviation Authority will provide me with the name and address of the investigating agency, the types of persons
to whom the agency inquired about me, and a complete and accurate description of the types of questions that
the Aviation Authority requested the agency to ask those persons.

(Initial) I understand that under the provisions of the Florida Statute 112.0455, Drug Free Workplace Act, the Aviation Authority established a drug-free workplace program and substance abuse policy. If offered
employment by the Aviation Authority, I will be required to complete a physical examination which includes a
urinalyses drug screening test. I understand that successful completion of the physical examination including a
drug screen is a condition of employment and adulterated or positive drug test results shall disqualify me from
further consideration for employment with the Aviation Authority for a two (2) year period. Refusal to submit
to a drug screen is equivalent to testing positive.

(Initial) The Aviation Authority complies with the American With Disabilities Act of 1990. During the employment application process, you may be asked about your ability to perform essential job functions. If you
are given a conditional offer of employment, you will be required to complete a Post Job Offer Medical History
questionnaire and/or undergo a medical examination. All applicants entering the same category will be subject
to the same examination and all information relating to the applicant’s medical history will be maintained on a
confidential basis in separate files. I understand that I will be requested to undergo a drug test as a condition of
employment.

(Initial) In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. The Aviation Authority will not sponsor applicants for work visas.

(Initial) I hereby acknowledge that I have read and fully understand each of the above statements.

How did you hear about employment opportunities with the Authority?

_________________________________________________________
Applicant Signature (signature will be obtained if selected for an interview)

________________________
Date

VETERANS’ PREFERENCE FORM

YOUR NAME: (Already entered above)

POSITION TITLE FOR WHICH YOU ARE APPLYING: (Already entered above)

VETERANS’ PREFERENCE INFORMATION

Completion of the Veterans’ Preference section below is made on a voluntary basis and kept confidential in accordance with the
Americans with Disabilities Act. Listed below are the four Veterans’ Preference categories.

A veteran with a service-connected disability who is eligible for or receiving compensation, disability retirement, or pension under public
laws administered by the U.S. Department of Veterans’ Affairs and the Department of Defense, or

The spouse of a veteran who cannot qualify for employment because of a total and permanent service-connected disability, or the spouse of
a veteran missing in action, captured, or forcibly detained by a foreign power, or

A veteran of any war who has served on active duty for one day or more during a wartime period, excluding active duty for training, and
who was discharged under honorable conditions from the Armed Forces of the United States of America.

A veteran who served honorably but who has not met the criteria for the award of a campaign or expeditionary medal for service, in
Operation Enduring Freedom or Operation Iraqi Freedom, qualifies for preference in appointment, effective July 1, 2007. The service
dates are defined as follows:

Operation Enduring Freedom - October 7, 2001 to date to be determined.

Operation Iraqi Freedom - March 19, 2003 to date to be determined.

Operation Iraqi Freedom has been renamed Operation New Dawn.

The unremarried widow or widower of a veteran who died of a service-connected disability, or

The Armed Forces Expeditionary Medal, as well as the Global War on Terrorism Expeditionary Medal are qualifying for Veterans’
Preference.

A DD214 or comparable document which serves as a certificate of release or discharge must be furnished at the time of application.
Veterans’ Preference is only available to Florida residents.

If an applicant claiming Veterans’ Preference for a vacant position is not selected, he/she may file a complaint with the Florida
Department of Veterans’ Affairs, P.O. Box 31003, St. Petersburg, Florida 33731-8903. A complaint must be filed within 21 days of
the applicant receiving notice of the hiring decision made by the employing agency or within 3 months of the date the application is
filed with the employer if no notice is given.

VETERANS’ PREFERENCE CLAIM

IF ELIGIBLE, WHICH VETERANS’ PREFERENCE CATEGORY ARE YOU CLAIMING?
(Please indicate number from Veterans’ Preference Information section above.)

ARE YOU A RESIDENT OF THE STATE OF FLORIDA? YES NO

NOTE: If you are claiming Veterans’ Preference you must meet the criteria and substantiate your claim by furnishing a DD214
(Certificate of Release or Discharge from Active Duty) and any other required supporting documentation with your application.

THIS INFORMATION WILL NOT BE USED TO EVALUATE YOUR APPLICATION AND WILL BE MAINTAINED SEPARATELY.

NAME: (Already entered above)

DATE: 8/2/2015

APPLICATION FOR: (Already entered above)

EEO RECORD KEEPING
(VOLUNTARY)

The Civil Rights Act of 1964 (Title 42, United State Code, Section 2000e, et seq.) and related laws and
regulations require employers to monitor their equal employment opportunity compliance on a continuing basis.
The information you furnish will be maintained only for the purpose of monitoring compliance with applicable
laws and regulations concerning equal employment opportunity and will not be used for any other purpose. This
information is being provided to the Authority voluntarily.

GENDER: (check one) Male Female

NATIONAL ORIGIN: (Check One)

WHITE (not of Hispanic origin)

ASIAN

PACIFIC ISLANDER

OTHER

AFRICAN AMERICAN (not of Hispanic origin)

AMERICAN INDIAN or ALASKAN NATIVE

HISPANIC

DISCLOSURE

This serves to advise you that in consideration for employment, a consumer report and/or investigative consumer report
may be obtained on you. This process may include verification of education; employment history; a review of any local,
county, state, and federal government agency records; court public records; and employment references. Employment
references may include information pertaining to your general character and reputation, work habits, and other
employment related characteristics

By signing this DISCLOSURE,

You acknowledge receipt of this Disclosure

You also acknowledge receipt of a "Summary of Your rights under the Fair Credit Reporting Act"

You give us permission to obtain a consumer report and/or investigative consumer report on you for employment purposes

You acknowledge that upon request, disclosure of the nature and scope of the investigative consumer report will be provided to you.

Received and Authorized by:

(Already entered above)
Printed Full Name

__________________________________________________
Signature (signature will be obtained if selected for an interview)